J and M’s Birth Story: Emergency C-Section at 33 Weeks

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Prematurity Awareness Week 2013: How Do You Do It?

World Prematurity Day November 17In the United States, 1 in 9 babies is born prematurely, 1 in 10 in Canada. Worldwide, over 15 million babies are born too soon each year. While not all multiples are born prematurely, a multiple birth increases the probability of an early delivery. Babies born prematurely, before 37 weeks gestation, are at a higher risk for health complications in infancy, some of which can have long-term effects. Full-term infants are not all free from their own health complications, of course.

In honor of November’s Prematurity Awareness Month, led by the March of Dimes, How Do You Do It? is focusing this week’s posts on The Moms’ experiences with premature deliveries, NICU stays, health complications, special needs, and how we’ve dealt with these complex issues.

Despite the reams I’ve written about motherhood over the years, I’ve never sat down to write my daughters’ birth story in its entirety. When they were newborn, I was too busy and it was too raw and painful. Later, every time I thought about blogging about it, I chose not to, fearing that I would frighten expectant mothers with my horror story. I just said, “They were born by emergency C-section at 33 weeks,” and left it at that.

From M and J's Birth Story from hdydi.com. Twins J and M were born prematurely at 33 weeks gestation in a rather dramatic birth, but did exceptionally well in the NICU and beyond.It’s not a horror story, though. In the end, my daughters are okay. They’re fantastic. They’re happy, healthy and whole; funny, sassy and smart; loving, considerate and goofy. Sure, I have my scars, but I have never felt the grief of losing a child or the very different grief that a child’s special needs will limit her options in life. It could have been so much harder.

The Pregnancy

I had a remarkably uneventful pregnancy, especially considering that I was carrying identical twins. I was tired, of course, and ate enough to feed a small family. I was eating for a small family, come to think of it. Other than that, though, I felt great. I had no morning sickness. I threw up once, but it was because the tap water in our new house was nasty. I did start having pretty severe Braxton Hicks contractions around 30 weeks, made worse if I allowed myself to get dehydrated.

Sadia and her husband, while expecting. From M and J's Birth Story from hdydi.com
I looked full-term at 31 weeks, but felt great.

My mother-in-law threw us a baby shower in Oregon, but my doctor strongly recommended that I not travel past about 25 weeks, so I stayed in Texas. At 31 weeks, my obstetrician recommended that I stop working the following week. In my great wisdom, I instead elected to work half-time, working from home 3 days a week and coming into the office twice.

My husband and I took our Lamaze class early, with other expectant moms two months closer than we to their due date, but I still never really considered the reality of the chances of our girls being born early. After all, the triplets in our family were born at 38 weeks! In fact, while I’d made my packing list and assembled the girls’ cribs by 30 weeks into the pregnancy, I didn’t pack right away and didn’t think anything of my soldier husband leaving for a week-long field problem in the wilds of Ft Hood when I was 32 weeks along.

The Babies Are Coming!

My husband returned home from his wilderness field problem, delighted to trade in his sleeping bag for our bed. My pregnancy was at 33 weeks. He was exhausted from having been in the field and I was exhausted from growing babies, so we went to bed early.

At 1:22 am, I was woken up by a cold wetness in my bed. I instantly knew that my water had broken. Later, I learned that only J’s water had broken. My babies were mono-di; their shared chorion had ruptured, as had J’s amniotic sac, but M’s amnion was still intact.

I woke my husband. He started mumbling about car seats and I realized that I was going to need to take control of the situation.

“It’s too early,” I told him, more calmly than I felt. “They won’t come home with us. We need to get to the hospital. Bring the insurance stuff and some books for me to read. You can come home for everything else.”

We called our doctor, who told me to use a maxi pad to catch the constant leak between my legs. On the drive to the hospital, I called my mother-in-law. She immediately started looking into airplane tickets to fly from Washington state to Texas.

The First Hospital

We had preregistered at our local hospital, so I went right into the maternity ward. The nurses took my maxi pad away to test it. While we waited, I changed into a hospital gown and my contractions started. After what seemed like an unnecessarily long time, a nurse returned to inform us of what we already knew. It was amniotic fluid and I was in labour.

The doctor on call at our suburban hospital told me that he was going to recommend that I be transferred to another hospital, Brackenridge in Austin. At the time, it was connected to our local Children’s Hospital and the best NICU around. Even though Brack wasn’t part of the hospital network we’d arrived at, our ob used to have privileges at Brackenridge and pulled strings to get an ambulance to transport us across hospital networks. There was no chance of the natural vaginal birth I’d hoped for. Both babies were breech.

“I would rather these babies arrive at the NICU inside you than after birth,” I remember the on-call doctor saying. “You also want to recover from your C-section in the same hospital they’re at so you can see them.” I wish I remembered his name. He was so kind.

My labour was progressing much too fast. My contractions were hard and fast but I was hardly dilated. While they arranged for the ambulance, they started me on a magnesium sulfate drip to slow my contractions. They also inserted a urinary catheter. They asked me if I’d be okay with a trainee nurse performed that procedure with an experienced nurse overseeing her. I agreed. I’m fully supportive of educational opportunities, but it did hurt.

The Ambulance

When the ambulance was ready and the paperwork done, everything happened very fast. I was rolled out into the ambulance bay on my bed, and tried to yell directions to Brack to my husband when I realized he’d be driving behind us. My impressions of the ambulance were of bright lights, sirens, bumps, increasingly painful contractions and a kind nurse with warm hands who tried to distract me from my contractions with questions about my hopes for my daughters.

Getting Settled at the Second Hospital

I later learned that my husband got lost on his way to the hospital. He called his mom in Seattle to get online and find him directions in Austin, Texas. She still marvels at the wonders of technology that early morning of May 10, 2006.

The on-call doctor came in and introduced himself, telling me that I was going to have an emergency C-section. I asked if there was any way to just deliver Baby A and leave Baby B in to gestate longer. He just said no and asked for me to start getting prepped for surgery.

The nurses checked how I was doing. They reported high protein in my urine and became alarmed. There was a rush of activity and a nurse came to see whether I had dilated any farther than my last measly 1 cm, reported at the first hospital. She went silent and I got scared.

“Um, where did you get catheterized?” she asked.

“At [the first hospital],” I told her.

“Well, they put the catheter in your vagina, not your urethra. You’ve got some serious bladder control, girl!”

They removed the catheter from my vagina. It hurt, far more than my full-bladder contractions. Once they got everything in the right place, the contractions became almost comfortable. I later learned that I’d been at risk of bladder rupture, thanks to the first hospital’s mistake.

They started my epidural. I’d be going under the knife awake, my lower body numbed. I was started to worry that my husband wouldn’t arrive on time.

The Delivery

He arrived just as I was being rolled into the operating room. I confess that I was too scared to notice much of what was going on. There were people in scrubs everywhere. They threw up a curtain across my body and strapped down my wrists. I remember thinking, “No, this isn’t supposed to be how they enter the world. This is all wrong.”

The doctor asked if I could feel anything below my waist. I could feel him pressing, I told him. He started to cut. Fortunately, all I felt was pressure. I was scared, but my husband was holding my hand. He was fascinated by what he saw on the other side of the curtain.

“J’s here,” he told me suddenly. I heard something that sounded like a kitten meowing. Her Apgar score was 9. I saw a flash of black hair and she was gone to the NICU. My husband was holding my hand again.

Splash. My husband guffawed.

“They punctured M’s sac and she splashed all over the doctor. That’s my girl,” he said proudly.

I heard more meowing, drowned by a delivery nurse’s urgent whisper. “There’s something wrong with her face!”

Her Apgar score was 8. One wrist was unstrapped so I could stroke her hair and then she was gone. I urged my husband to follow her to the NICU, but he reminded me of our agreement to let him stay with my until I was sewn back up. As soon as the last staple was in, he disappeared.

The First Day

I lay in my recovery room. It was 6:45 am and I was a mother who couldn’t do a thing to parent her own children. I waited until 8:00 and called my coworker Dustin to tell him that I wouldn’t be at our morning meeting… or any meetings at all for a while. I later learned that he took the brunt of our female coworkers’ wrath, since I failed to give him the girls’ birth statistics and he failed to ask.

A nurse came into check on me and deliver a hospital breast pump. She told me that my husband had been very forceful in his insistence that I be given every opportunity to breastfeed. I looked at the pump equipment and figured out how it fit together. I started pumping, as I would do every 3 hours without fail for the next weeks that my daughters were in the NICU.

I began to regret having told my husband to stay with the babies. I wanted to know how they were doing. The recovery nurse promised to ask. Soon, our friends Kaylan and Markus arrived. Kaylan was horrified that I hadn’t seen any photos of the babies yet. She marched off to the NICU and returned with two photos on her phone.

Our concerns for M’s health are a matter for another post. I was running a fever, so I couldn’t see the babies. When my husband came into my room to see me, he noticed me cradling my belly. I was feeling the lack of sensation (which wouldn’t return for months) but he was concerned for my mental health.

New parents of twins shortly after birth from hdydi.com

“You had the babies,” he told me. “They’re not in there any more.”

“I know!” I told him, but I’m not sure he believed me.

All I could do was pump. I pumped and pumped and pumped and nothing came. I remembered a coworker telling me that his wife’s milk never came in. Their (now perfectly healthy) daughter was born so early that mom’s body interpreted the birth as a stillbirth, not a live birth. I felt like a useless hunk of meat.

My mother-in-law arrived and asked me to call my therapist. I did, and we had a session over the phone. I felt a lot better after talking through all my irrational feelings of failure at my daughters’ premature arrival.

The Second Day

My colostrum came in. I got a tiny golden drop on the side of each of two preemie bottles. I paged the nurse and asked the woman who arrived to please take the bottles to the NICU.

She picked up the bottles and turned them in the sunlight. “You want me to take this to them?” she asked incredulously.

“No,” I snapped, my dams breaking and the tears beginning to pour. “I don’t want you to take that. Give them back.”

The nurse supervisor heard me sobbing and came in to see what was going on. I told her between my sobs that I’d finally done something good for my babies, some act of actual motherhood, by producing colostrum and felt judged by the nurse for not having more. She comforted me, saying that I was right, that colostrum was liquid gold and every speck would help my babies. She would walk the colostrum over to the NICU herself. They would pour formula into the bottles to make sure that every last bit made it into my children. I should keep pumping and she would make sure I got a visit from the lactation consultant.

Sadia wearing a surgical mask and holding J.When my babies were 36 hours old, at 6:00 pm on their second day, my husband managed to wear someone down and convince them to let me visit the NICU. I wore a face mask since my fever was so recent.

I’d seen photos and been warned, but the NICU was overwhelming. My sense of smell was still working overtime as it had while I was pregnant. The pain from my incision when I stood from the wheelchair to scrub into the NICU mixed with the smell of the soap. I still can’t visit that hospital network and smell that soap without feeling the twinge in my uterus and heart. It’s been over 7 years.

The beeps of the machines seemed too loud and I panicked when I realized that I didn’t know which babies were mine. My husband wheeled my over and parked me between their open isolettes. I wanted to know why they weren’t being cobedded. I was told that hospital policy had recently changed and multiples were no longer allowed to share an isolette in the NICU.

b_124333I tried to hide my irritation and fear by asking about what the all the machines, wires and tubes did. The nurse surprised me by lifting M into my arms. I had no idea that I was going to be allowed to hold her. She was so small. I was reminded again of a kitten, although I confess thinking that she and her sister both looked like a cross between a lizard and a monkey. Her face and ears were still furry with lanugo. I could see where her eyebrows began only because they were was a thin line of hairlessness outlining their upper edges.

It wasn’t long before I learned that my daughters were doing exceptionally well, despite their gestational age and despite their 3 lb 6 oz and 3 lb 9 oz birth weights. They were “feeder-growers,” in the NICU only to eat and grow. Since they were born before their baby fat developed, they needed help maintaining their body temperatures outside the womb. Since they were born when they should still be nourished through the umbilical cord, feeding was a challenge. Other than size and feeding, they were perfect… apart from whatever might be wrong with M’s nose.

That’s a story for another day.

My own recovery was much slower and more painful than I anticipated. In my eagerness to visit the NICU, I kept tearing my staples out and reopening my incision. That too, I think, is a story for another time.

Sadia (rhymes with Nadia) has been coordinating How Do You Do It? since late 2012. She is the divorced mother of 7-year-old monozygotic twins, M and J. She lives with them and their 3 cats in the Austin, TX suburbs and works full time as a business analyst. She retired her personal blog, Double the Fun, when the girls entered elementary school and also blogs at Adoption.com and Multicultural Mothering.

From the Archives: Twin Birth Stories

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Prematurity Awareness Week 2013: How Do You Do It?

World Prematurity Day November 17In the United States, 1 in 9 babies is born prematurely, 1 in 10 in Canada. Worldwide, over 15 million babies are born too soon each year. While not all multiples are born prematurely, a multiple birth increases the probability of an early delivery. Babies born prematurely, before 37 weeks gestation, are at a higher risk for health complications in infancy, some of which can have long-term effects. Full-term infants are not all free from their own health complications, of course.

In honor of November’s Prematurity Awareness Month, led by the March of Dimes, How Do You Do It? is focusing this week’s posts on The Moms’ experiences with premature deliveries, NICU stays, health complications, special needs, and how we’ve dealt with these complex issues.

We’ll be sharing more twin birth stories throughout the week. Here are the ones that have been published on HDYDI in the past.

Have a multiple birth story to share? Please link to it in our blog hop or tell us about it in the comments. We especially want to hear about how things went for higher order multiples!

Mom Twins – A Story of Parallel Coincidences

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My husband and I were still in college when we were expecting.  We were active in our church congregation where we also learned that another couple was also expecting, and would you believe, had the same due date as us!  It was a pretty funny coincidence.  I mean who shares a due date with someone they know personally?

My husband and I didn’t find out we were expecting twins until our first ultrasound appointment at 18 weeks gestation.  We were shocked when the ultrasound technician said, “Did you know you were having twins?”  Of course we didn’t!  We were utterly surprised.

We had fun announcing at church the following Sunday that we were having a little girl… and another little girl!  The couple that shared our due date was like, “You’re making us nervous!  We have our ultrasound appointment this week.  What if we are having twins too?”

And wouldn’t you guess, this couple had their ultrasound appointment to confirm that they too were also having twin girls!?Twins Pregnancy Belly Block LettersWhat are the chances of that happening, that two people who live in the same city, not far from each other, would have the same due date and both be having twin girls as their first pregnancies?

Oh, and we even had the same doctors to boot!  And we both moved to larger apartments before our babies were born.  The parallels were astounding.

It was fun and exciting having someone to share this new phase of life with, even though we didn’t really know them that well.  We found ourselves bonding to them from our shared circumstances. She and I were going through our twin pregnancies, something that few people get to experience, let alone with someone they know, at the exact same time.  We would greet each other with, “So, how is my twin?”  We were each others’ twins. We were mom twins.

As our pregnancies progressed, we got to know each other better.  We went to each other’s baby showers and complained to each other, and stressed to each other. We compared stories of ultrasounds, non-stress tests, prenatal vitamins, whether we liked our doctors or not, our worries about having a C-section, twin names, how we planned on feeding our babies, needed baby gear and nursery décor, and so much more.

As the end of our pregnancies neared, we found we were both able made it to the full-term mark.  And guess what?  We were both scheduled for Cesarean sections, and for the same day.  Her Baby A was breech, and both of my girls were breech, and since we were full-term, were scheduled, by our shared doctors, to be delivered via Cesarean section on the same day, at 37 weeks 6 days gestation.  My twin mom was scheduled a few hours before myself.  Our twin daughters all share the exact same birthday.

Our twins have twins.

While we both stayed at the hospital for a few days recovering from our surgeries, we took some time to go visit each other’s rooms at the hospital and ooh and aah at each other’s new babies.  Her twins look very identical, while mine do not.  We talked about how our deliveries went, our recoveries, and how breastfeeding/bottle-feeding were going so far.

And wouldn’t you know, the names we picked out for our twins even shared some similarities?  I had an Alison Louise, she an Eloise.  I had a Lisa, and she had a Lucy.

Now that more than three years have past since our lives were brought together and shared in a such a fun, unique, and rare happenstance, we find each other living far apart, in different states.  We don’t talk very often, as we were never really that close of friends, but every year on my daughters’ birthday, I always think about my twins’ twins, and my Mom twin, wishing them happy birthdays too.

Maybe someday we’ll find the opportunity to get these two sets of twins together and let them play.  How fun that would be.

And I always wondered if our lives would find more parallels, but for the most part, they haven’t.  While there are other things that are kind of similar, this twin phenomena is quite enough already!

Have you ever met someone who shared so many similarities to you? At the same time?  Do your twins share a birthday with another set of twins?  Did you know another pregnant woman expecting twins (or other multiples) when you were? Let me know!

ldskatelyn is the proud mother of three-year old twin daughters and a three-month old bouncing baby boy.  She finds humor in her twin coincidences, and was thankful to have someone to share it all with.  Find out more about her and her family at What’s up Fagans?

Twin Pregnancy vs Singleton Pregnancy

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I had twins first.  Unexpectedly.  I didn’t even know there were two little peas in the pod until an 18 week ultrasound said there were.  Surprise for sure.

So, I have wondered since what that singleton baby pregnancy would be like.  Would it be similar?  Would I get as big, as my womb was already very stretched out from the previous two occupants?  How long would I go since I didn’t have a cut-off gestational date quite like I did with twins (38 weeks)?  How much weight would I gain with just one baby?  How would I feel? Would I end up with another C-section?  And many other similar questions swam through my head.

I’m sure I’m not the only mother of twins who had these questions.  While not all twin moms have their set of twins (or other multiples) first, many do.  And for these women, I would like to answer the above questions as they applied to me.

First, my pregnancy overall was very similar in how I felt, especially in those first few months.  But, I had less morning sickness/nausea this time around, though that could have had more to deal with the fact that I was at home all day and could eat a little something any time I needed to, unlike when I was pregnant with my twins and was going to school full-time and in the marching band as well.  I had a similar amount of heart burn, indigestion, and fatigue.   I didn’t have as much of a problem with varicose veins or Charlie horses this time though.

Having only one child swimming around inside of your belly is much different than having two or more.  I could much more easily and readily guess what those lumps, jabs, and swooshes were going on inside of my abdomen.  With twins, you not only have a harder time guessing what body part that was, but whose it was as well.

Joyously,  I didn’t gain as much weight (my biggest fear) the second time around!  With the twins I gained about 50lbs, going to almost 38 weeks gestation with them.  With one baby I gained about 35-40lbs and went to just shy of 42 weeks gestation.  However, with the singleton pregnancy, I started to show much sooner than I did with the twins.  But, I’m pretty sure that’s just how most subsequent pregnancies go though.  (See my twin belly montage post HERE)

And I did and didn’t get as round.  While my belly did end up sticking out as much as my twin pregnancy (basketball/torpedo style), there was a difference: I wasn’t as round at the top.  I still had room under my rib cage.  I could breathe easier with a singleton pregnancy, even at the end.  And the one little guy didn’t kick me in the ribs.  With twins, I had no room under my rib cage as there was a child floating around up there!  (See my 40 week singleton belly picture HERE)

I didn’t gain any more stretch marks on my belly (as if I could), but I did get stretch marks on my butt, of all places.  My belly didn’t itch hardly at all like it did when I had two in there.  I still had round ligament pain, lots of Braxton-Hicks contractions, and a baby pinching those sciatic nerves, though.

But, I was really nervous about giving birth, however.  Since I had a scheduled C-section with the girls, I didn’t even know what a real contraction felt like.  I didn’t know how I would handle it.  I didn’t know how much it would hurt.  I knew I wanted a vaginally delivery, but I was scared.  So, I read several birthing books, and tried to prepare the best I could, although I never did make it to any birthing classes.  Thankfully, I handled the early contractions and labor fairly well, though I did end up getting an epidural after more than 24 hours of labor.

But, I am so happy to report that I did not have a repeat C-section!  I was able to deliver my singleton son vaginally. (Read his full birth story HERE.)  While doing so meant I had the wonderful privilege of waiting 13 days after his due date until I was able to hold him in my arms, I am so glad I had a successful VBAC.

With twins at home, I did not want to laid up in the hospital for 3-4 days, be on drugs for several weeks, and have a hard time picking them and other toys and things up around the house.  (Read THIS post for more of my reasons to opt for a VBAC.)  I wanted an easier, quicker recovery from childbirth, especially since we would not be having any help after we came home.

To my happiness, it is indeed how my recovery was with a VBAC.  My son is now 6 weeks old, and I have been feeling great, most of the time.  My body has bounced back much quicker.  I was only on a simple ibuprofen for about a week postpartum, not codeine for two weeks.  My bottom was sore instead of my abdomen.  A VBAC meant that I was still able to take care of my twin three-year olds by myself.  I was able to comfortably pick them up for the first time in months (no pregnant belly in the way).  I had more energy to play with them, after a short while, as I was no longer winded after I climbed the stairs, like I was while pregnant.

Also, my son spent zero time in the NICU.  One of my twins, though born at almost 38 weeks, spent two days in the NICU, recovering from a partially collapsed lung.  With my singleton birth, I also got to hold my child immediately afterwards, unlike with the twins.  I didn’t hold either of my girls until four hours had passed after delivery, and then only one of them.  With my son’s birth, I was able to leave the hospital after a short 38 hours after giving birth.  I stayed four days at the hospital after I had my C-section delivery of my twins.

If you had twins first, how did your pregnancy compare to a subsequent singleton pregnancy?  Better or worse?  Did you have a repeat C-section (if you had one the first time)?  What did you fear most?

ldskatelyn is a wife, and proud new mother to a six-week old boy and three-year old fraternal twin daughters.  She is enjoying adjusting to life as a mother to three and enjoying having her body (mostly) back after being pregnant for nine long months.  She blogs about her life and family over at whatsupfagans.blogspot.com

Am I Being Responsible?

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I keep assuming that my experiences this pregnancy will be similar to the ones I had in my singleton pregnancies. I have been wrong over and over again. My first Ob appointment was no exception… totally different.

My Dr. started my first visit by saying ” I know since you’ve done this three times you feel like you’re an expert, but you’ve never been pregnant with twins”. He then went through a whole list of ways this pregnancy would be different: 2 gestational diabetes tests, more weight gain, more caloric demands, no more running, more appointments, more ultrasounds. None of those phased me. Then he hit me with “Now you know you’ll have to labor and deliver in the OR and you’ll have to have an epidural.”


He then went on to explain that he understood how I felt about having natural births, but I needed to get comfortable with a very different experience “For the safety of the babies”. When I asked if I could try laboring without an epidural he said that it was my choice but “he’d just put me under when it was time for my C-section”

I literally didn’t know how to respond. So I didn’t.

With each of my births I have used less and less intervention. W’s  had the works: pitocin, epidural, the Dr. broke my water, and constant monitoring. G’s had a little less. O’s was intervention free: My water broke at home, no pain meds, no IV, and intermittent monitoring. I am proud of and happy with all of my births. They each resulted in a healthy baby. One of my friends asked me recently why I prefer natural birth. I explained to her that she competed in triathlons and I had babies. I love the challenge of getting through the pain and watching what my body can do. I am seriously weird in that I look forward to labor.

When I found out I was pregnant this time my husband and I decided that we’d like to use a midwife and deliver at a free standing birth center. He’s an ob/gyn so this decision didn’t come easily for us. We talked and talked and read and read. We felt confident in our decision. Then we found out it was twins and our plans changed.  We agreed that we both felt safer having the babies at a hospital. We felt better knowing that if something did happen we’d have experts on hand to help and  we wouldn’t have to waste time getting to a hospital.

So here’s my dilemma: How much intervention is needed in order to be responsible?  I had already happily come to terms with delivering in a hospital.  I’d also decided that I could deal with having  to labor and deliver in the O.R., but is having an epidural really necessary? Also, why is my Dr assuming I’ll have to have a C section?  And telling me he’ll “just put me under”? is he being flippant?

All I want is the CHANCE to have these babies vaginally without an epidural.  Is that being irresponsible?

I’ve had one more visit with Dr. Doom (my new name for him) since the awful first one.  I didn’t have the nerve to bring up our discussion.  I didn’t ask any questions and realized I was smiling and shaking my head a lot.  If you asked him I’m sure he’d say the visit went fine.  I left the appointment feeling like I either need to find a new Dr. or  have a very open conversation with him. Neither of those options sound particularly fun.

Per my usual I have launched into research mode. I’ve questioned other twin moms about their experiences, I’ve read all I can find on birthing multiples, and I have talked with my husband and a midwife friend about their approaches to delivering twins.  I’ve learned a lot and in the end I think I’ve realized that I still need to know more. So much of this decision to birth vaginally or by C section and with what interventions is dependent on my babies.

Right now my plan is to become comfortable with not knowing how I will give birth to these babies. This is very hard for my type A uber organized self.  I still want the chance to deliver naturally, but I won’t dig my heels in and refuse other options. I think being open is the only responsible choice.

Talk to me about your birth experiences. Anyone deliver their babies naturally? How much intervention did you find was truly necessary? Would you change anything about your birth?


Elizabeth lives in Central Texas with her husband and 3 sons.  She is 13 weeks pregnant with twins. 


Family Planning with Twins

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Having twins rocked my world, I’m not going to lie. I never considered twins a possibility when I thought about starting a family and even skipped all the sections on twins in my prenatal books until I found out it was happening to me. Only weeks after my husband and I deciding we were going to start a family, I became pregnant. 10 weeks after that, we found out it was twins. I was shocked, surprised, scared, and any number of S words you can use to describe ones emotions. I kept telling myself that since these twins were natural, I was going to be spared from the laundry list of twin pregnancy risks you are told about. “It was meant to be” was my mantra for 38 weeks and I whole-heartily believe it.

Pregnancy was not what I would call easy, but looking back, it was not terrible either (likely because I do not know any different). I had morning (noon and night) sickness for 18 weeks, I had weeeeeeks of feeling really great, and then I had 3 weeks of bed rest to keep my little guys cooking away as long as possible. Because both babies were breech, I ended up having a c-section at 38 weeks despite my being a student of the Bradley method. My c-section experience was not textbook, I am sad to say, and I ended up hemorrhaging after delivery. Although it was scary at the time, I recovered quite well and have been assured that it was a flukish thing that can happen when you have twins and is not likely to happen if there are future pregnancies.

Now that my guys are 15 months old, my husband and I are starting to reflect on whether or not we should increase the size of our family. I never thought I would be asking myself this question after only one pregnancy. Because I waited until after I finished my PhD and post doc to get pregnant, I figured I would pop out two kids, one right after the other, to make up for not getting pregnant in my 20’s. (Turns out- this is what happened but instead of 1.5 years between kids, there is 1.5 minutes, ha!). I pictured myself having two kids but I thought I would have to have two pregnancies to get them. Now that I have twins, I am wondering if we should roll the dice again and try for more children. I know it is commonplace to be pregnant while you are raising a toddler but, in truth, it scares me. I am (worrying) wondering how you effectively parent twin toddlers while creating the life of a third? How do you start the clock again on sickness, tiredness and breastfeeding baby(ies?) right when your toddlers are bursting with energy? How do you change your parenting techniques to raise a singleton when you are so used to parenting twins?

Deciding whether or not to have children is a very personal decision and I am not asking to have that debate. I am, however, trying to explore the worries that come with being twin parents who are thinking about adding other children to the family. How do you do it?

New Author Intro

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Categories Birth Stories, Family, Fraternal, Parenting Twins, Pregnancy1 Comment

Hello everyone!

I figured I need to introduce myself while I still have the time.  My name is Katelyn Fagan and I blog over at What’s Up Fagans? 

At 24 years of age I find myself as a wife, a Brigham Young University  graduate, a part-time artist, a member of the Church of Jesus Christ of Latter-day Saints, and a stay-at-home mom to fraternal twin daughters.  My family and I currently live in Indianapolis, IN, USA though I was born and raised in Wisconsin, USA.  My husband and I met while attending our respective colleges out in Utah, which is where we later delivered our twin daughters.  Currently my husband is a part-time graduate student and part-time university math teacher.  Our fraternal twin daughters, Lisa and Alison, will be three next month, and we are expecting our third baby, a boy, ANY day now (I’ve past my due date).  We are excited to finally be able to meet and hold our little boy, and nervous about parenting kids at different ages.

I look forward to writing on How Do You Do It? and getting to know you all better!  I try to write honestly about my struggles as a parent, a person, a Christian, as well as a financially challenged family, with some humor and hopefully some optimism too.

If you want to get to know me better, here are a few posts I have written that you may find interesting:

I look forward to sharing and learning about twins and other multiples!  What a joy we all share!


Katelyn Fagan of whatsupfagans.blogspot.com

Four Boys=Two Sets of Twins

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Categories Birth Stories, Family, Famous Twins, Higher-Order Multiples, Identical, Multiple Types, Multiples in the News, PregnancyTags , , 2 Comments

If you love Valentine’s Day, you’ll love this story.  On Valentine’s Day last week, a Texas couple welcomed the new additions to their family–all four of them.  Tressa Montalvo gave birth to the couple’s second through fifth sons last Thursday at The Woman’s Hospital of Texas after carrying them for 31 weeks.

The couple were originally told they were expecting twins before hearing four heartbeats.  The verdict?  Two sets of identical twins!  Conceived without any fertility treatments, the chances of this happening are one in 70 million. According to the mother, their plans for this pregnancy “succeeded a little too much.”  The boys, named Ace, Blaine, Cash and Dylan (A-B-C-D), are healthy and could be going home in the next four to six weeks.

I can only imagine the comments people must be throwing at them…from “double the double trouble” to the obligatory “you’ve got your hands full,” to the well-intentioned “now you’re done!”  But you might be surprised at Manuel’s reaction to the last one.  He’s still hoping for a girl!

Congratulations to the happy family!  Who knows, maybe soon we’ll be seeing them around HDYDI?

Click Here to see the CBS video clip.

No Birth Plan for You!!

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Categories Ask the Readers, Birth Stories, Pregnancy25 Comments

I’ve seen a midwife for my gynecological care for the last 12 years or so. I have preferred their approach of treating the health of the woman, over the potential sickness. The different women I’ve seen have always taken their time to answer my questions, never rushing out of the room and have made me feel comfortable. When I envisioned myself someday giving birth, I pictured a hospital, but having a midwife coach me through. This vision was thoroughly reinforced after seeing “The Business of Being Born” and having several friends deliver healthy babies, in uneventful births with midwives by their sides.

When we found out we were having twins, we went to see a midwife I’d seen a handful of times and who had helped me through my miscarriage. Her recommendation was to see both the OBs in the office, as well as the midwives throughout my pregnancy and that I’d be “shared” by them, most likely resulting in a birth attended (in the OR for certain) by both a CNM and OB. Last week I saw one of the OBs, and while I did feel comfortable, the difference between a midwife and OB approach is notable. I was thrown for a loop when this OB was strongly recommending that I see only the OBs in their practice. Her rationalization was that most likely, I’d end up with one of them delivering my babies, anyways, so why not start with them. She explained that a variety of scenarios are likely to arise that would require them to step in: if I had a vaginal birth and the second baby was breech, if I needed a planned or emergency c-section, or need to use forceps to avoid a c-section. Essentially, she was saying that things would have to be picture perfect for a midwife to deliver both twins start to finish.

On the one hand, I’m trying to let go of the visions I’ve had in the past of a particular kind of pregnancy, labor and child-rearing. In a way, I feel silly to not just work with the doctor who has delivered FAR more sets of twins than my midwife, and feel that I should work toward accepting the doctors will do whatever is safest for my babies and me on D-day. The other, more stubborn, feminist part of me gets upset at the idea of having a pregnancy that could be pathologized from this point forward: labeled as “high-risk” and having the OB drive the train that she desires. I’m terrified of ending up with a c-section because I went with an OB who wanted to get things over with (which, admittedly, may be an unfair judgment of all OBs), when I could have had a vaginal birth if I went with a midwife.

I’m curious to hear from others who may have been faced with this dilemma. How did you decide whether to see a midwife or an OB? Did you end up just scheduling a c-section, to avoid all the potential ups and downs of a vaginal twin delivery? Did you try for a vaginal birth with your multiples, but end up with a c-section anyways, after complications got in the way? I’d love to hear any thoughts, advice or perspectives I’m missing.


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Categories Birth Stories, Breastfeeding, Development, Formula, Infants, NICU, PrematurityTags , , , , , , 11 Comments

I got the best news in a long time today. A college friend’s twin boys were reunited at 2 months old. Her second NICU baby got to come home from the hospital, 7 weeks after his brother.

In the middle of the joy I felt for my friend, though, I felt an upwelling of the sadness, anger and helplessness that tainted the joy of my own babies’ release from the hospital, over 5 years ago. Homecoming is one of the ways that the NICU experience can differ for parents of premature multiples in comparison to preemie singletons. Many twins and triplets are released from the hospital simultaneously, but many are not.

Our daughters were born 7 weeks early, but had few problems apart from their small size. J had a hole in her heart, which eventually resolved itself, and M had a facial cleft that turned out not even to require surgery. Neither of these conditions required hospitalization, so they were textbook “feeder growers,” newborns who were hospitalized until they had fattened up enough to maintain their own body temperature and had the strength to suck enough nutrition to keep them healthy.

Our girls didn’t need any assistance breathing; they’ve been verbal and long-winded since the start. They were keep in warm isolettes, and fed a mixture of high calorie formula and my breast milk through feeding tubes inserted through their noses and threaded into their stomachs. Every three hours came a diaper change, weighing, blood sugar measurement, temperature measurement and feeding. We watched every number as they rose and fell, and I promised myself I would take notes when they got home so as not to double feed one baby and starve the other. J and M were cared for by the same nurse, so their schedules were offset by 15 minutes. One benefit to having NICU babies was that they were on a clockwork schedule by the time they came home.

There were 3 criteria to be met, we were told, before the girls could come home. They had to weigh 5 lbs (2.25 kg), be able to maintain their own body temperature, and take 8 meals in a row by mouth, drinking at least 31 mls of formula/breast milk each time. Every now and then, when J asks for her “warmed up milk, please,” at breakfast or dinner, I wonder at the way she guzzles 8 oz of milk down and think back to the days I tried to get her drink 1 oz by force of will alone.

We wanted all the girls’ energy to go to growing at first. Somewhere in the first week, I think, they were introduced to doll-sized bottles. It took a few tries to get them to suck, first 1 ml, then 3, more and more each meal. They finally made it up to 31 mls at a time, but couldn’t keep it up two meals in a row. It was just too much work.

M couldn’t finish her bottle at every feeding, but she made an effort. Once, I was even allowed to let her suckle at my breast, although the nurses took her away before she exhausted herself. J was less predictable. She’d suck like a champ and then suddenly get distracted, seemingly more interested in playing with the bottle than drinking from it. Two weeks in, she broke our hearts by refusing two meals in a row and being put back on her feeding tube. It was the only time I saw my husband so upset that he couldn’t stay in the NICU to monitor every last detail of our babies’ care. A friend took him out for a beer.

When our girls were 2 weeks old, the hospital staff pronounced them to be the healthiest babies in the NICU. They could afford to be downgraded to a less fancy-schmancy NICU within the same hospital network. We talked it through and agreed to free up their beds. However, when the paperwork arrived, we were asked to sign a waiver releasing both the hospitals and the ambulance service of responsibility for the babies during their transport. There was no way we were signing that, so the girls stayed put.

Two days later, M was ready to come home. She hadn’t quite made the weight cutoff, but they couldn’t see any reason she wouldn’t be just fine at home. She passed the carseat test, and home we went.


J was still on her feeding tube. I felt more torn as a mother of twins in that moment than I ever did before or since. I was celebrating the health of one of my daughters, but leaving the other alone at the hospital, without even her sister with her. My husband was away for an army training exercise, and I was still recovering from my C-section. Fortunately, my father-in-law was able to stay for 3 weeks, and drove us the 30 miles to the hospital every day so that I could deliver breast milk and steal a few moments with J. I couldn’t stay too long, though, since M was in her carseat in the hospital parking garage with Grampy.

After 5 long, agonizing days, J was ready to come home. It finally felt like my life as a parent could start. My friend just ended 48 days of that waiting, and I hope that her heart can finally begin to heal.

Did you get to bring your babies home at the same time?

Sadia’s daughters, M and J, are still short for their nearly 6 years, but Sadia is short for her nearly 33, so it works out nicely. They guzzle milk, grow, and keep each other busy in El Paso, TX.